TOTAL CLAIMS
FOR
NUMBER FILED
NUMBER EXTRA
TOTAL CHARGEABLE CLAIMS
)j minus 20=
INDEPENDENT CLAIMS
IO minus 3 =
*
MULTIPLE DEPENDENT CLAIM PRESENT
□
PATENT APPLICATION FEE DETERMINATION RECORD
Effective October 1 , 2001
Application or Docket Number
90 fp^RW-m >
CLAIMS AS FILED - PART I
* If the difference in column 1 is less than zero, enter "0" in column 2
CLAIMS AS AMENDED - PART II
(Column 1) (Column 2) (Column 3)
CLAIMS
REMAINING
AFTER
AMENDMENT
Minus
HIGHEST
NUMBER
PREVIOUSLY
PAID FOR
PRESENT
EXTRA
Total
Independent
• t
Minus
-it)
FIRST PRESENTATION OF MULTIPLE DEPENDENT CLAIM ' □
Total
Independent
(Column 1)
CLAIMS
REMAINING
AFTER
AMENDMENT
(Column 2)
HIGHEST
NUMBER
PREVIOUSLY
PAID FOR
(Column 3)
FIRST PRESENTATION OF MULTIPLE DEPENDENT CLAIM
PRESENT
EXTRA
CLAIMS f^j^i^k^
REMAINING ■ " : SS
AFTER (SX— K
AMENDMENT E
HIGHEST
NUMBER
PREVIOUSLY
PAID FOR
PRESENT
EXTRA
Total
*
Minus
**
s
Independent
*
Minus
«**
m
FIRST PRESENTATION OF MULTIPLE DEPENDENT CLAIM | |
SMALL ENTITY
type rzzi
OTHER THAN
OR SMALL ENTITY
SSOJ
• If the entry In column 1 is less than the entry in column 2, write "O" in column 3.
- If the "Highest Number Previously Paid For" IN THIS SPACE is less than 20. enter '2
***ff the "Highest Number Previously Paid For" IN THIS SPACE is less than 3. enter "3."
The "Highest Number Previously Paid For" (Total or Independent) is the highest number found in the appropriate box in column i
RATE
FEE
RATE
FEE
baric FEE
O/U.UU
OR
BASIC FEE
740.00
X$9=
OR
X$18=
/<? -
X42=
OR
X84=
+140=
OR
+280=
TOTAL
OR
TOTAL
Mb
OTHER THAN
SMALL ENTITY
OR
SMALL ENTITY
ADDI-
ADDI-
RATE
TIONAL
FEE
RATE
TIONAL
FEE
X$9=
OR
X$18=
X42=
OR
X84=
+ 1*HJ=
OR
+280-
TOTAL
Annrr ccc
OR
TOTAL
ADDIT PPP
ADDI-
ADDI-
RATE
TIONAL
FEE
RATE
TIONAL
FEE
X$9=
OR
X$18=
X42=
OR
X84=
+140=
OR
+280=
TOTAL
ADDIT. FEE
OR
TOTAL
ADDIT. FEE
ADDI-
ADDI-
RATE
TIONAL
FEE
RATE
TIONAL
FEE
X$ 9=
OR
X$18=
X42=
OR
X84=
+140=
OR
+280=
TOTAL
OR
TOTAL
ADDIT. FEE
FORMPTM75 (Rev. 8/01)
H*J S nPO.Wl «1M>4 ' 54197
Patent and Trademark Office. U.S. DEPARTMENT OF COMMERCE
BEST AVAILABLE COPY